Thursday, April 10, 2014

Symptoms To Watch For In Your Dog: Nose Bleeds (Epistaxis)

I already emphasized how important it is to take your dog’s nose bleeds seriously in Bella’s story. I am talking about bleeds directly from the inside of the nose, not surface bleeds where you might be able to actually find the wound and determine the cause quite easily.

Because of their anatomy, dogs don’t get nose bleeds with every little bump to the nose as people do.


Nose bleeds are upsetting and messy and hardly escape attention. Particularly since dogs often also start sneezing as a result of blood in their nostrils. If the bleeding isn’t stopping on its own, you will quite likely rush your dog to the vet.

When it does stop, though, should you still go to see your veterinarian?

Like with everything else, it depends.

If it was just one little bleed and it stopped on its own, no, I would not rush my dog to the vet.


Jasmine had a little nose bleed once. Very little blood and it stopped quickly. She was fine otherwise. It WAS possible that her nose bleed was from a nose-to-nose impact with JD when they both tried to grab a toy at the same time.

I did not rush to the vet but I did bring it up during her next appointment. Nothing wrong was found and her nose never bled again.

But what if the nose keeps bleeding, or it happens more than once?

Could your dog have fallen off somewhere and have an internal injury? Could there be a foreign body lodged inside the nose or deeper within the respiratory tract? Could your dog have been exposed to rodenticides? Is your dog on any medication? Could your dog have an infection? Could your dog have severe dental disease? Could your dog have a serious disease or even cancer? Are there any worrisome signs accompanying the nose bleed?

Serious trauma

With a serious trauma, there will usually be other signs, such as evidence of physical injury or neurological damage. Signs of a serious problem could be as subtle as pupils that don’t react to light properly or as serious as balance issues, seizures or loss of consciousness. Does your dog look and act normal? Are both pupils the same size? Do they shrink when you direct a flashlight towards them?

Signs of internal bleeding can include rapid heartbeat, rapid or deep breathing, pale or bluish gums, lethargy, weakness, unsteadiness, confusion, glazed eyes, and loss of consciousness.

Foreign body

Does one nostril seem congested? Some foreign bodies in the nasal passage can be quite dangerous, such as foxtails. Not only do foxtails cause a local problem but they can enter through the nose, ears, paws or skin, travel through the body and make their way into internal organs.

A dog with a foreign body in his nose is also likely to sneeze violently, shake their head or show other signs of distress and discomfort.

Foreign bodies can also become lodged in the lungs or airways leading to them and result in blood that may drain from the nose.

Rodenticide poisoning

Many rodenticides are anticoagulants, which means they adversely affect the ability of blood to clot. Your dog might also vomit blood or bleed from the gums or rectum. This can be accompanied by internal bleeding. Besides a nose bleed, your dog could also be weak and unstable, have difficulty breathing, have bruising under the skin or swelling of the abdomen. Their gums might be pale.

Drugs

Some medications can increase the risk of bleeding, such as some antibiotics, chemotherapy drugs and aspirin. Aspirin acts as a blood thinner and reduces clotting capability.

Infections

Some fungal organisms and bacterial infections can also result in nose bleeds. Particularly tick-borne diseases such as Rocky Mountain spotted fever or Ehrlichia.

Ehrlichia causes a reduced platelet count (cells that help the blood to clot), resulting in nose bleeds or other abnormal bleeding. With Rocky Mountain spotted fever, the bacteria can also infect and damage the lining of blood vessels.

Other symptoms might include fever, depression, lethargy, loss of appetite, enlarged lymph nodes, difficulty breathing, painful and swollen joints …

Blood clotting disorders

Disorders that affect proteins (clotting factors) or cells (platelets) that help the blood to clot , such  as Von Willebrand's disease (VWD), hemophilia, immune-mediated thrombocytopenia, result in abnormal bleeding, including nose bleeds.

Dogs suffering from a clotting disorder can have prolonged or excessive bleeding after injury, blood in urine or stool, skin bruising, bleeding from gums and nose …

Liver failure

Spontaneous bleeding occurs in dogs with advanced liver disease or liver failure because the liver is responsible for making clotting factors.

Liver failure can have many causes; all it took for Jasmine was one event of severe drug-induced hyperthermia. Among other things, she was bruising all over, including the skin over her abdomen and tongue (those were the places where it could be seen easily).

High blood pressure

Hypertension (high blood pressure) can also cause nosebleeds. Dogs can develop high blood pressure as a result of another disease (like kidney failure) or as a primary problem with no detectable underlying cause.

Cancer

And last but unfortunately by far not least,  recurring nose bleeds can be caused by nasal tumors. In fact, nasal tumors are the most common cause of persistent nose bleeds in dogs, especially in individuals with longer than average snouts.

If your dog has recurrent nose bleeds, put cancer on top of your list of things to look for or to, hopefully, rule out.

Symptoms may include intermittent and progressively worsening nasal discharge and/or bleeding form one or both nostrils. In some cases you can see facial deformity. Neurological signs might be present if the tumor is invading the brain cavity.

But don’t panic. Some more benign causes of nose bleeds are nasal polyps or nasal mites. Nasal mites often cause irritation to the nose and a lot of sneezing or reverse sneezing. Polyps are benign growths but can affect a dog’s ability to pass air normally through the nose. The good news is both of these conditions can be cured with appropriate therapy.

With nose bleeds, be on your toes. Do take this symptom seriously, particularly if the bleeding is severe or keeps happening.

Related articles:
Nose Bleeds? Bella's Nasal Cancer
The Easy Answer Isn't Always The Right Answer: Buddy's Nosebleeds

Symptoms: Recognition, Acknowledgement And Denial
Symptoms To Watch For In Your Dog: Excessive Panting
Symptoms To Watch For In Your Dog: Excessive Drinking
Symptoms To Watch For In Your Dog: Bad Odor 
Symptoms to Watch For In Your Dog: Excessive Drooling  
What Can Your Dog's Gums And Tongue Tell You? 
Symptoms To Watch For In Your Dog: Coughing 
Symptoms To Watch For In Your Dog: Excessive Head Shaking  
Symptoms To Watch For In Your Dog: What Is That Limp? 

Further reading:
Nose Bleeds in Dogs
Epistaxis: The Bloody Nose
Epistaxis (Nose Bleed) in Dogs

24 comments

  1. I've never seen a dog with a nose bleed. I think now I would be a little less freaked out...or more...depending on the criteria you mentioned. I did walk outside my apartment door once to find three baby squirrels that had fallen out of a tree. They were bleeding from the mouth, having difficulty breathing and clearly dying. I didn't really know but I guessed that the mama squirrel got into the rat poisoning the landlords were using. I rushed them to PAWS but one didn't make it there. It didn't look too good for the other two either. When I told the landlords, they could't have cared less! Your description of rodendicide reminded me of that.

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    1. Rodenticide poisoning is a nasty death; and now they make new kinds which don't even have an antidote at all ...

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  2. just dropped my doberman off this morning at the vet, he was bleeding out of one nostril all night, and I'm so glad I found your page.... everything else I found on dog nosebleeds was very depressing. my doberman has been on antibiotics for some sort of virus, pretty high potency, and I'm glad to see that could be a cause, because otherwise I would be freaking out. I hope that is the cause!!

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    1. I hope that is it too. Please let me know how he's doing.

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  3. Wondering what kind of virus? Is your dog doing better on antibiotics? Only asking because our dog is experiencing the same thing. At the ER last night for blood test and everything is normal. They are thinking it's a nasal tumor and a CT is next on our list.

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    1. If the blood checks out, and there are no tick borne diseases or anything else showing on the labs, yes CT scan is next on your list, sorry. Tumors are a relatively common cause of nose bleeds.

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  4. My black lab was an amazing, I say was she was 20 years old but still acted like and looked like a puppy she was a family member one day she had a intense nose bleed first time anything wrong had ever happened in her 20 years. It stopped she seemed fine but a week later a mucus/blood discharge started showing up when she was laying down a week after that after more than 2 dozen vet visits to different vets the Vet could not find the problem but told us we needed to put her down. Absolutely hardest most devastating thing I had to do. It still gets to me if they would of told me what it was I would probably have a little more ease but the not knowing and wondering of even though she spent more than a 3rd of my life with me for 20 years did she have to go right then what if she would of just gotten better.There is nothing more special then the bond I had with her.

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    1. So sorry about your baby. She had a good life and an awesome daddy. Bonds like this cannot be broken even by death of the physical body.

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    2. My lab was just 3 he had the same he recovered his platelets so fast but all of a sudden blood again popped out of his nose and at clinic he was on drip then suddenly he collapsed.... Those eyes were in pain :(

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  5. One of our dogs had nosebleed 3days ago. It was really bleeding unceasingly . What my father did was he bathe the dog andthe bleeding stopped. Just today, it reoccured. My mom bathe our dog so that the bleeding would stop. I think our dog shows no signs of loss of appetite, weakness, etc. In fact, he eats a lot and fast. What i just noticed is his sneezing at times. We think that his case is caused by the hot weather in our country at the moment. Is it possible that the hot weather contributes to the nosebleed of our dog?

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    1. No, hot weather shouldn't cause nose bleeds unless there is something else going on as well. Please do have your dog checked out. I'd also run bloodwork to see whether there might be some clotting issue, which combined with the heat leads to bleeding.

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    2. Hot weather in itself should not contribute to nosebleeds. However, things that come with hot weather could. those things can be anything from foxtails or other awns, fungal infections, tick-borne infections ... I would have this looked into.

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  6. Our mixed breed puppy 9 months old, started bleeding through his nose 3days ago. The vet could not see us yesterday. He died today. As I was picking him up to take him to the vet.

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    1. Lydia, so sorry for your loss. Sounds like it must have been a lot of bleeding, possibly some clotting issue ... ? Sorry he couldn't get help in time.

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  7. i cannot get my dog to the vet. he just had a sneezing/nosebleed episode. what can i do to stop the bleeding until morning? HELP HELP HELP please.

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    1. Hon, posting emergencies as comments on blogs is not the best plan; there isn't likely somebody around around the clock. I hope you've seen a vet by now ... ?

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  8. I've had my 5 year old yellow lab to the vet 2 times, she has blood work done the last time. She's been in antibiotics for almost a week. Her nose had slowed down with the bleeding but today I notice its running again plus her breathing is raspy. She has a lump on her head that also looks larger. I feel helpless. She's still eating and drinking. All her bloodwork come back fine, no bleeding disorder or cancer but something is defiantly not right :(

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    1. Something is definitely not right. I'd expect the lump on her head and the nose bleeds to be related. I believe that's where they need to focus - finding out what the lump is from. Whether it's cancer, abscess, infection, something to do with a foreign body such as a foxtail ... Blood work isn't really a conclusive way to rule out cancer particularly if there is a lump. The lump needs to be aspirated or biopsied so the lab can look at the cells and find out what it from. Might need to do ultrasound or x-rays.

      I'd be quite convinced the lump and the bleeding go hand in hand, particularly if no blood disorder was found.

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  9. My golden is just 7 years old. He started with a clear runny nose (both nostrils) and a head tilt. Took him for x-rays and blood work which were all normal. Had an MRI / Spinal Tap when he wasn't getting better. Diagnosed with encephalitis. After high dosing of prednisone he seemed to at least recover from the encephalitis. Just last night he had a nose bleed from one nostril with clotting......... Have an appointment with the neurologist. Any thoughts??

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    1. Unfortunately, I can't tell you what is going on. Was he vaccinated recently?

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  10. Looking for your thoughts. I have a 12yo golden retriever who started with occasional nose bleeds about 6 weeks ago and brief breathing episodes. Sort of wheezing for 30 seconds to a minute. No eatting issues, he's 12 so normally not very active. Took him to the vet about a month go now. Did blood work... came back positive for heart worm. We are now in the middle of scheduling the heart worm procedure but he still has the nosebleeds. Basically daily! Some just a drip or 2 but a couple have been bad. I'm worried that something else just as serious as the heart worm is going on and worried about doing the harsh heart worm treatment! Michele D.

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    1. So sorry to hear. I don't believe HW would cause nose bleeds unless there are actually worms in the blood vessels there. I recommend some imaging to take a good look at what is going on with the nose. At least x-rays and/or ultrasound.

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  11. I have a 13 year old male golden with bleeding out of his right nostril. His first time to the vet they ran blood work. He was on phenobarb for seizures years ago so his liver isn't 100%. I took him off of that when it was making him ungodly thirsty and I learned of the damage it could do down the road. The vet gave him antibiotics and a shot of epinephrine up the nose. The vet said that it would most likely be a tumor in the frontal lobe but did tell me it would be costly to do extra tests and the works. So fast forward two months later (just yesterday) his nose started bleeding again. :/ I'm super bummed. The vet gave me antibiotics and a shot up the nose again and said we can keep doing that until the time comes. He's eating, drinking, playing just fine and is happy. I'm more than honored to have a dog that's 13 and my goal is to keep him happy until the last day. Just have to remember quality over quantity. His quality of life is more important than how many more years I selfishly want him around. <3

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    1. I'd be concerned about a tumor as well. If you can afford that, I would go through with some imaging etc to determine whether that is the case, what tumor and what location. Could be just a foreign body too, for all you know. If it is a tumor, I'd see whether cryosurgery could be done, or stereotactic surgery. Provided you could afford that.

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